SVCA Application for Admission

If your child will be 5-years-old by September 1, (s)he is eligible to enroll in our Kindergarten program. We provide an excellent Kindergarten learning experience. Our students are taught the fundamentals of reading, and most of the students are reading phonetically by the end of the first semester. They are prepared for future academic success by establishing strong reading and math skills. Kindergarten students must submit a a completed 1) Application for Admission, 2) the registration fee, 3) a copy of their birth certificate, and 4) a copy of their immunization record.

Grades 1-12

Admission to Spring Valley Christian Academy is based on an application. Parents are expected to agree with the school's Statement of Faith, regularly attend and participate in the life of a Christian Church, and give evidence of their positive relationship with Jesus Christ. Elementary students must submit a completed 1) Application for Admission,

2) the registration fee, 3) a copy of their birth certificate, and 4) a copy of their immunization record.

Grades 6-12

Admission to Spring Valley Christian Academy is based on an application and a Pastoral Interview. The Pastoral Interview is a screening process for both the school and the prospective family. During the interview, the parents will be given the

school's Statement of Faith and the Parental Support Statement. Both parties must be in agreement that the Academy would be a good "fit" for the student. Parents are expected to regularly attend and participate in the life of a Christian Church and give evidence of their positive relationship with Jesus Christ. Students should demonstrate potential academic success in our program based on previous records and recommendations. All prospective students should demonstrate good social adjustment, satisfactory behavior, and emotional stability. Each middle school and high school student must submit a completed 1) Application for Admission, 2) the registration fee, 3) a copy of their birth certificate, 4) and a copy of their immunization record. The Pastoral Interview is conducted with the parents of the prospective student, the student, and the Pastor.

There is a $100 nonrefundable fee for the Pastoral Interview which is paid prior to the date of the Interview. If the prospective student is denied admission, the $100 will be refunded to the family. If admission is granted, the $100 will be applied towards the registration fee.

Fees

All fees are payable prior to the first day of school.

STUDENT INFORMATION

Name (first, middle, last)

Date of Application

Street Address

City, State, Zip

Date of Birth

Gender (male or female)

Place of Birth

Grade to be Entered

PARENT/GUARDIAN INFORMATION

Father’s Name

Father’s Cell

Street Address

City, State, Zip

Employer

Occupation

Business Phone

E-mail

Mother’s Name

Mother’s Cell

Address

City, State, Zip

Employer

Occupation

Business Phone

E-mail

PREVIOUS SCHOOLS

School Name/Address

Grades Attended

School Name/Address

Grades Attended

Emergency Information

In the event of an emergency, S. V. C. A. will contact the following people based upon the order in which they are listed. Please list parent and/or guardians first, then list additional individuals who are emergency contacts and authorized to pick up your children.

EMERGENCY CONTACTS

Name

Parent/Guardian

Cell Phone

Work Phone

Name

Parent/Guardian

Cell Phone

Work Phone

Name

Relationship

Cell Phone

Work Phone

ADDITIONAL PERSONS AUTHORIZED TO PICK UP CHILD

Name

Relationship

Cell Phone

Work Phone

Name

Relationship

Cell Phone

Work Phone

Medical Information

1. Does your child have a history of the following: Asthma_______________ Allergies____________

2. Does your child have any other health problems? __________________________________________

3. Is your child allergic to any medications? __________ If yes, please list_________________________

Spring Valley Christian Academy admits students of any race, color, and national origin to all rights, privileges, programs, and activities made available to students in the school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, administration policies, or in any other school administered program.

SVCA Tuition Rates

Registration

Kindergarten, Elementary,

Middle, and High School

$495

Nonrefundable

Application Fee

For all Middle and High School Students

(Grades 6 and up)

$100

(Applied towards Registration/Tuition upon acceptance.)

Tuition Rates

Kindergarten

$4,000/year

Elementary

$4,500/year

Middle School

$5,000/year

High School

$5,500/year

SVCA Tuition Agreement

Tuition will be paid by (choose only one):

__________ OPTION 1 Payment in full.

Single payment payable on or before July 15, 2013.

__________ OPTION 2 Ten monthly payments, payable on the 1st of each month.

__________ OPTION 3 Ten monthly payments, payable on the 15th of each month.

I understand that Spring Valley Christian Academy cannot function without my timely financial support and I do hereby agree to pay all tuition and fees required in accordance with the financial policy of the school. There will be a $25 return payment fee if the funds are not available. Accounts that become thirty (30) days past due are subject to student dismissal.

(a) an exempt private school which receives a “certificate of exemption” from the Nevada Department

of Education to confirm the school’s exempt status, as requested by the school which qualifies and

chooses to be exempt from licensing.

(b) and a licensed private school which is licensed by the Nevada State Board of Education.

The Nevada Department of Education recognizes both types of schools as alternatives to public schools.

Both types of private schools have to:

Provide curriculum, exclusive of religious instruction, that is equivalent instruction of the kind and amount approved by the State Board of Education – and follows the Nevada State standards as found on the Nevada State Department of Education website.

Provide minimal length of school day and school year.

Comply with all applicable state, county, and local health, safety, and fire inspections and laws, ordinances, and regulations, including those relating to fire emergency drills, vehicles and immunization of pupils.

Spring Valley Christian Academy is licensed by the Nevada State Board of Education. Thank you for helping us maintain our religious distinction and exempt status.

Spring Valley Christian Academy offers no guarantees or warranties, stated or implied, as to the literal transferability of any student’s educational progress upon termination from the Academy. All educational entities, whether public or private, have complete authority to independently assess the academic progress of any prospective student and provide appropriate placement. Once a student leaves Spring Valley Christian Academy there is no recourse directly available as to the placement of any student in any other educational establishment.

FIRST: Participant signing below represents that he/she/they are legal guardian(s) of the minor child(ren) named above, and

SECOND: The parties acknowledge that PWCC is a Nevada Non-Profit Tax-Exempt Religious Corporation, with principal offices located in Las Vegas, Nevada, among which are large campus grounds, PWCC buildings and other multipurpose facilities and structures, including athletic fields and parking areas; all of which are distinguishable separate or isolated locations. PWCC makes no representation regarding the suitability of the premises for any reason or purpose. Participant has conducted its own independent examination of the premises determining for itself that same is suitable for its purposes contemplated by this agreement.

Disclaimer, Waiver, Release and Authorization

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THIRD: PARTICIPATION DISCLOSURES AND WAIVERS

Participant and PWCC understand and agree that there are a number of various programs undertaken by departments and groups in affiliation with PWCC, on and off the PWCC campus facilities, involving activities and individuals that are often not under direct control or supervision of PWCC, and that there is an overriding policy that each participant involved in these programs does so at their own risk of personal injury or damage to property; and Participant and/or the named minor child(ren) desires to take part in the activity mentioned hereinabove, and fully understands and agrees that such activity might involve sporting activities, travel or contacts with other individuals or groups, and that PWCC has limited or no control over other individuals involved in such activity, and that there is always the risk of physical injury, illness, and other loss, and possible costs or expenses for medical or dental diagnostic and curative treatments, and general and special damages for incidental loss or expense, and, in these premises, Participant does for himself/herself, and for and on behalf of said child(ren) and his or her family, representatives and heirs, assume the risk of all such injury, responsibility or liability, and waives any and all claims or causes of action against PWCC or its agents that might arise from or on account of any sort of loss or injury of or to person or property of any description in this regard; and as an inducement to PWCC and its agents to allow the undersigned and such child(ren) to participate in such activity, does hereby agree to hold harmless PWCC and its agents from all these things in event any such claim should arrive. PWCC does not act as insurer, guardian guarantor, or warrantor of health or safety of anyone involved in such activity. The undersigned affirmatively represent that said child(ren) has special needs and conditions or requires special medication and care only as follows:

STATEMENT OF HEALTH:

1. Does your child have any health problems? ______________________________________________________

2. Has your child ever had any physical handicaps or limitations? _______________________________________

3. Is there any history of mental illness in your family? ________________________________________________

4. Has your child ever been convicted of a criminal offense? ____________________________________________

(excluding minor traffic violations)

If you answered yes to any of the above questions, please explain. _______________________________________

List any medications or treatment that should not be given to your child because of dangerous reactions: _________

I/we further agree to provide on an immediate need to know basis any change in information that may arise at any time.

Disclaimer, Waiver, Release and Authorization

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FOURTH: MEDICAL AUTHORIZATION

In the event it should become necessary, which in emergency or otherwise, where the said child(ren) cannot act for himself or herself, consent is hereby given for PWCC through its adult individuals serving as its agents to arrange for and consent to X-ray examinations, anesthesia, dental, medical or surgical diagnosis and/or treatment and hospital care, for said child(ren), on behalf of Participant, and, in such event Participant agrees to assume and pay all costs, charges, fees and expenses incurred in the premises, and to hold harmless PWCC, its agents, assigns, employees, and volunteer assistants from any liability whatsoever due to the administration of first aid and treatment arising out of injury, sickness or damage which may be sustained by said child, therefrom. Participant represents and agrees that he or she already has or will provide insurance coverage or payment of such things, at Participant’s own expense.

FIFTH: DISCIPLINE

Participant for himself/herself/themselves and on behalf of such minor child(ren) hereby submits to and agrees to abide by all rules and regulations, supervision and discipline set and applied by PWCC or its agents, and it is agreed that for violation of such rules and regulations, supervision or discipline, the participation in the activity may then be immediately terminated, without liability on PWCC or its agents. In the event your child is dismissed from the program, we, the undersigned, agree to forfeit any possible refund, make restitution for any damages and assume full responsibility for transportation home.

SIXTH: I/we consent and agree that said child may travel with the __________________________ on a trip sponsored by the Spring Valley Christian Academy of , its agents, assigns, employees and volunteer assistants from any liability whatsoever arising out of injury, sickness, or damage which may be sustained by said child during the course of said trip.

The following student(s) has (have) applied for admission to Spring Valley Christian Academy. Please release the academic and behavioral records, including all standardized test scores, record of immunization, and report cards, for the current and past year.